Distribution Information

AAE members may reprint

this position statement for
distribution to patients or
referring dentists.
Concerning
Paraformaldehyde-
Containing
Reaffirmed October 2017.
Endodontic Filling
Materials and
©2017

Sealers
AAE Position Statement
The American Association of Endodontists (AAE) is dedicated to maintaining the
highest quality of care in the practice of endodontics. As part of that dedication,
the AAE actively supports the use of safe and effective materials in connection
with root canal treatment. The AAE recognizes that legitimate differences of
professional opinion may exist as to the “safest” or “most effective” material for
a specific patient or specific circumstances. In recognition of those legitimate
differences of professional opinion, the AAE does not endorse the use of specific
materials. However, the AAE does recommend against the use of paraformaldehyde-
containing materials as they have proven to be both unsafe and ineffective.

Paraformaldehyde-containing endodontic filling materials or sealers

(frequently known as Sargenti pastes, N-2, N-2 Universal, RC-2B or RC-2B
White) should not be used for endodontic treatment because those materials
are unsafe. Paraformaldehyde-containing filling materials and sealers can
cause irreversible damage to tissues near the root canal system resulting in
destruction of connective tissue and bone, intractable pain, paresthesia and
dysthesia of the mandibular and maxillary nerves, and chronic infections of
the maxillary sinus. Moreover, scientific evidence has demonstrated that the
damage from paraformaldehyde-containing filling materials and sealers is
The guidance in this
statement is not intended not necessarily confined to tissues near the root canal. The active ingredients
to substitute for a clinician’s of these filling materials and sealers have been found to travel throughout
independent judgment in the body and have been shown to infiltrate the blood, lymph nodes, adrenal
light of the conditions and glands, kidney, spleen, liver and brain.
needs of a specific patient.

AAE Position Statement – Concerning Paraformaldehyde-Containing Endodontic Filling Materials and Sealers | Page 1
Public health concerns and litigation have made the AAE
aware of a significant number of patients who have suffered
injuries as a result of treatment with paraformaldehyde-
containing filling materials and sealers. Undoubtedly, there
are many other patients who have also suffered injuries
because of these materials, but whose injuries have not been
publicly disclosed.
Safe and effective root canal filling materials and sealers
are available. In light of the availability of safe and effective
alternatives, the American Association of Endodontists
recommends against the use of paraformaldehydecontaining
filling materials or sealers because the use of such is below
the standard of care for endodontic treatment.
References
1. Brodin P, Roed A, Aarg H, Orstavek D. Neurotoxic effects of
root filling materials on rat phrenic nerve in vitro. J Dent
Res1982; 61: 1020-3.
2. Block RM, Lewis RD, Hirsh J, Coffey J, Langeland K. Systemic
distribution of N2 paste containing 14Cparaformaldehyde
following root canal therapy in dogs. Oral Surg Oral Med Oral
Path Oral Radiol 1980; 50: 350-60.
3. Hata G, Nishikawa J, Kawazocs, Toda T. Systemic distribution
of 14C labeled formaldehyde applied in the root canal
following pulpectomy. J Endod 1989; 15: 539-43.
Revised April 2013

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